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Jul 28 2016 10:OOPM HP FaxRusty Olson 7634988290 page 4 <br /> Property address: 2940 Fox_Street, Orono MN Inspectar initials/Date: J. 0.7/08/16 <br /> 4. Soi( Separation -Compliance component#4 of 5 <br /> Date of instailation: 5/31/Q6 ❑ Unknown Ve�ifrcation method(s): <br /> ShorelandM/ellhead protectioNFood Beverage <br /> Lodging? ❑Yes � No Soi!obse�vation does nof expire. Previous soil <br /> observations by two rndependent parties ar�s��cient, <br /> Com (iance criteria: unless site condrfions have been altered orloca! <br /> �quirements diNer. <br /> Forsysfems burlt priorto Apri11, 1996, and ❑Yes ❑ No <br /> not located in Shoreland orWeUhead III � Conducted soil observation(s}(Attach boringlogs) <br /> Protection Area ornot serving a food, , ❑ Two previous veriflcations(Attach ba�ng logs) <br /> 6everage orlodging esiablishment: <br /> I ❑ Not applicable(Holding tank(s),no drairtfield) <br /> Drainfield has at least a two-foot verlical ' ❑ Unable to verify(See Gomments/Explanation) <br /> separation distance from periodically <br /> saturated soil or bedrock. � ❑ Other(Ses CommentslExplanation) <br /> Non-performance systems built Apn!1, i �Yes ❑ No Comments/ExpJanation: <br /> 1996, or lafer or for non-pe�fom�ance � <br /> sysfems located rn Shoreland or We!lhead I <br /> Protecfion Areas orserving a food, <br /> beverage, orlodgingestablishmenf. <br /> Drainfeld has a three-foot vertical � <br /> separation distance from periodically 'i <br /> saturated soil or bedrock.' I <br /> � <br /> "ExpenmenfaP; "Other; or "Performance" ,I ❑ Yes ❑ No Indicate depths of elevations <br /> sysfems built under pre-2008 Rules; Type!V i <br /> or V systems builtunder2008 Ru1es(7Q80. A. eottom of distribution media l 99.0 <br /> 2350or7080.2400 (Advanced Inspector <br /> License required) B Periodicalt saturated soiVbedrock � 96.3 <br /> Drainfield meets the designed vertical � C. 5 stem se aration 2.7 <br /> separation distance from periodically I� <br /> saturated soil or bedrock. 0. Required compliance separation' ; 2 6 <br /> Afly "n0"answer above indicates the sysfem is �May be reduced up to 15 percent if allowed by Local <br /> Failing to Piotect Groundwater. _ _ ordinance. <br /> 5. Operating Permit and NitrO�en BMP*—Compliance component#5 of 5 � Nat applicable <br /> Is the system operated under an Operating Permit? ❑ Yes ❑ No If"yes",A below is required <br /> Is the system required to employ a Nitrogen BMP? ❑ Yes ❑ No If"yes",B below is required <br /> BMP=Best Management Pract�'ce(s)speciBed rn the system desrgn <br /> If the answer to both quesiions rs "no", this sectiorr does not need to be complefed. <br /> Com iiance criteria <br /> a, Operating Permit number. <br /> Have the Operating Permit requirements bsen met? j ❑Yes ❑ No <br /> b. Is the required nitrogen BMP in place and properly funclioning? ❑Yes � No <br /> Any "no"answer indicates Noncompliance. <br /> Upgrade Req uirements (Minn. Sfat.§ 1�5.55)An imminent threat to publrc health and safety(17PHSJ musf be upgraded,rep/aced,orits use <br /> discor6nued wrthin fen months o1 receipf of this nofice or withirt a shorter period if required 6y loca/orri�nance.If the sysfem is failing to profect <br /> ground water,the system must be upgraded,replaced, or its use disConfinued within the time required by loca!orcfinance.If an ezisting systam <br /> is not failrng as defi�d in Jaw,ar+d has at leest hvo ieet of desrqn soil separation,then the system need not be upgraded,repaired,replaced,or <br /> its Use disronfinued,rotwlthslanding any local ordinance that is more strict. This provrsion does not apply to systems in shoreland areas, <br /> Wellhead Prorection Areas, or those used in connection with food,beverage,and lodging establishments as def;ned in law. <br /> www.pca.state.mn.us • 65t-296•630D • 800-657-3864 • TTY 651-282-5332 or B00-b57-3864 . Available in altemative formats <br /> wq•wwtsts4-31 • 1/24/f7 Poqe 3 of 3 <br />